Impacts of the preferred option

Opportunity to improve standards of stroke care

This preferred option reduces the fragility of the stroke service and raises standards by bringing together the staff across fewer sites. 

It allows further consolidation of specialist staff than some of the other options previously considered by the Board. It brings together acute stroke specialist care (beyond initial treatment) for stroke patients within the Hywel Dda area at one hospital site.

This preferred option reduces the fragility of the stroke service further because it provides 24-hours of specialist cover, seven days a week. This would allow for a more intensive first 72 hours of care and improved patient outcomes.

This option would focus specialist stroke therapy on two sites, Bronglais and Glangwili hospitals, rather than across four sites. This would help with staffing challenges and potentially be more attractive to future staff, as well as improve clinical standards and patient outcomes.

This would specifically help us to meet the standards by:

• ensuring we have the right staffing levels in our acute stroke unit and stroke rehabilitation unit
• ensuring that we have sustainable staff rotas so that we can offer services seven days a week
• enabling us to meet more SSNAP measures by having access to staff and services
• creating community rehabilitation capacity with Integrated Community Stroke Services which are aligned to standards
• increasing access to TIA clinics in line with stroke standards
• sustained support to education, training and research opportunities for all stroke trainees

The quality statement for stroke services sets out a vision for how stroke services should be provided in Wales. Part of this includes bringing together stroke specialists in fewer hospitals to create Comprehensive Regional Stroke Centres (CRSCs). These are 24-hour, seven day a week centres that support the highest level of care for the first 72 hours, including thrombolysis, thrombectomy, diagnosis, monitoring and rehabilitation. Currently there are no CRSCs in Wales, and the national programme for stroke is looking at how we can plan and deliver these in the future.

In our preferred option we talk about regional working. This could be:

• one of our hospitals hosting elements of a CRSC, as it is unlikely we would be able to develop all of the services a CRSC can provide (such as thrombectomy), or
• working with another health board in the region who provide parts of these services for our patients